Jacqueline Ann Imbrogno, MS, CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS01119300 Issued in NJ

Practice address

57 E Merchant St
Audubon, NJ 08106-1059

Phone

(610) 804-8382

NPI assigned

Jun 1, 2023

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Ann Greto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1003509282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 ROUTE 70 W STE 2",
            "address_2": "1141",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "610-804-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 E MERCHANT ST",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081061059",
            "telephone_number": "610-804-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBROGNO",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "MS, CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009251",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01119300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "GRETO",
            "middle_name": "ANN",
            "credential": "MS, CCC-SLP/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Audubon, NJ
• Providers in Audubon, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.